Unhealthy living habits and excessive weight could potentially age the heart by up to 45 years.
Assessing Heart Health with Cardiac MRI
Understanding the condition of your heart is vital in preventing heart issues early and discovering effective solutions. Recently, a study revealed an innovative approach to determine a person’s heart's functional age compared to their biological age.
This study employed a model based on cardiac magnetic resonance imaging (MRI), which discovered that certain health conditions, such as obesity and atrial fibrillation (AFib), coupled with an unhealthy lifestyle, can lead to an accelerated functional heart age.
Participants with specific health issues experienced distinct heart changes that varied from healthy aging. The findings were published in the European Heart Journal Open.
Investigating Heart Health with Cardiac MRI
Researchers involved in this retrospective observational study aimed to explore a method for measuring heart age, considering how various modifiable risk factors could hasten the heart's aging process. One promising instrument to examine the heart's structure and performance is cardiac magnetic resonance imaging.
Utilizing a healthy reference population of 191 participants, researchers contrasted them to a testing group of 366 individuals with at least one comorbidity, like high blood pressure, diabetes, or obesity. Additionally, they employed another group of 25 people for “preliminary external validation.”
Participants hailed from five distinct locations across three countries. Researchers had the opportunity to evaluate several components of heart structure and function. Subsequently, they created a model to help calculate the age of participants' hearts, and performed several statistical analyses.
Distinct heart variations were observed between the healthy and unhealthy groups, including a higher median ejection fraction within the unhealthy group, which evaluates the strength of the heart's contractions.
The final model researchers used focused on left atrial end-systolic volume and left atrial ejection fraction, which both assess the performance of the heart's upper chamber. These two factors stood out as parameters significantly related to age among 169 healthy participants.
Connections between Health Problems and Heart's Premature Aging
The researchers found that healthy participants' heart ages closely matched their real age. Conversely, unhealthy participants observed heart ages above their chronological age. The cardiac MRI-derived heart ages were almost five years older than the chronological age of these participants.
Obesity emerged as a factor that elevated the functional age of the heart, with increased weight resulting in greater heart years. Participants with a body mass index (BMI) of 40 or higher boasted a functional heart age forty-five years higher than their chronological age. For participants with atrial fibrillation (AFib), heart functional age was also higher than that of healthy participants.
Functional heart age was sometimes higher for other comorbidities in certain age groups. Particularly, in participants between the ages of 30 and 69, participants with high blood pressure experienced increased functional heart age vis-à-vis healthy participants in the same age bracket.
A similar trend was observed for diabetes, with the most significant increase seen in the 40 to 49-year-old group. However, in the 70 to 85-year-old group, participants with diabetes and high blood pressure displayed lower functional heart ages than healthy participants of the same age.
Study author, Pankaj Garg, MD, PhD, Associate Professor in Cardiovascular Medicine at the University of East Anglia, Norwich, UK, highlighted several key findings.
"We have discovered an equation-a simple math formula-that uses movies from heart MRI scans to figure out how old your heart looks. For healthy folks, their heart age matches their real age. But if someone has conditions like high blood pressure, diabetes, a wonky heartbeat, or extra weight, their heart can look way older-about 4.6 years older on average. For people with a lot of extra weight, their hearts looked up to 45 years older!"- Pankaj Garg, MD, PhD
Study Limitations
This research represents an encouraging development in more effective cardiac health monitoring, but it also delivers limitations. Initially, the work involved estimations and aimed at calculating the functional age of the heart. Second, considering the study's non-long-term nature, there's a higher risk for survivor bias, potentially underestimating the impact of comorbidities on older individuals. Thirdly, researchers did not track the duration that participants had these measured comorbidities. Consequently, it's possible that there was variation among unhealthy participants regarding comorbidity exposure. Bias is noted in some of the calculations. Researchers also acknowledged the possibility of selection bias. This research did not assess certain factors, like exercise and diet.
Researchers admitted that there could have been variation in the unhealthy group due to medical treatments.
Researchers applied certain exclusion and inclusion criteria, affecting who they were able to incorporate into the study. For instance, they excluded people with severe chronic kidney disease, which is a contraindication for the MRI scans they employed. The development of the age calculation model involved making numerous decisions, which researchers may find opportunities to refine.
Patrick Kee, MD, PhD, a cardiologist at Vital Heart & Vein not involved in the study, noted several potential limitations, including the study’s inability to examine long-term data, lack of other measurements that could have been helpful, and the use of a simple model that focused on left atrium end-diastolic volume and left atrium ejection fraction.
Long-term studies will likely prove beneficial, while assessing how changing factors like lifestyle could help alter outcomes.
"The model was preliminarily validated on a small cohort, necessitating larger-scale validation to confirm its reliability and robustness for clinical application. Furthermore, it remains unclear whether lifestyle and therapeutic interventions will alter the trajectory of the heart age due to underlying medical conditions." - Kee noted.
Potential Applications of Heart Age Assessment
Cheng-Han Chen, MD, a board certified interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA, who was not involved in the study, remarked that determining the functional age of the heart could serve as a valuable preventive measure.
"An assessment of a 'functional heart age' (either through imaging or other biomarkers) can potentially motivate patients to improve their lifestyles, identify patients at risk for future clinical events, and possibly even evaluate response to clinical therapeutics and interventions." - Cheng-Han Chen, MD
Using cardiac MRI also possesses an allure due to its ease of use.
"Heart MRI scans are completely noninvasive tests-meaning no cuts or needles-and for checking the heart age, only a few minutes of this test are required. If necessary, this can be done in a focused way to help lots of people quickly. That might help catch heart trouble early and stop bigger problems, like heart failure, later on," Garg explained.
Finally, there could also be improved communication between doctors and individuals at risk for heart problems. As the authors in the study suggested, this could help people understand the need for changes.
"By comparing a patient's 'functioning heart age' with their 'chronological age,' clinicians can effectively communicate 'cardiovascular risk' to encourage lifestyle and therapeutic modifications. This approach can also serve as a tangible measure to motivate patients toward preventive strategies like weight management, blood pressure control, and diabetes management to mitigate the progressive decline in heart health. Tracking changes over time allows clinicians to adjust treatment plans before irreversible damage occurs." - Patrick Kee, MD, PhD
- The study published in the European Heart Journal Open employed cardiac magnetic resonance imaging (MRI) to determine a person's heart functional age compared to their biological age.
- Obesity and atrial fibrillation (AFib), coupled with an unhealthy lifestyle, can lead to an accelerated functional heart age, according to the study.
- Participants with specific health issues, like high blood pressure, diabetes, or obesity, exhibited distinct heart changes that varied from healthy aging.
- Utilizing cardiac MRI can help assess the heart's structure and performance, making it a promising instrument for heart health monitoring.
- Researchers created a model using left atrial end-systolic volume and left atrial ejection fraction to help calculate the age of participants' hearts.
- Obesity elevated the functional age of the heart, with increased weight resulting in a higher heart age.
- Participants with a body mass index (BMI) of 40 or higher had a functional heart age forty-five years higher than their chronological age.
- Study limitations included estimations, potential survivor bias, and the exclusion of certain factors like exercise and diet.
- Research on heart age assessment could potentially motivate patients to improve their lifestyles and identify those at risk for future clinical events.
- Improved communication between doctors and individuals at risk for heart problems could help patients understand the need for changes and track their progress over time.
